B B Sharma

High Resolution Computed Tomography Lung Spectrum in Symptomatic Adult HIV-Positive Patients in South-East Asian Nation

BACKGROUND Pulmonary infections remain a leading cause of morbidity and mortality and one of the most frequent causes of hospital admission in HIV infected people worldwide. HRCT may be useful in the evaluation of patients with suspected pulmonary disease. The aim of given study was to determine the High Resolution Computed Tomography spectrum of lung parenchymal and interstitial imaging findings in HIV infected patients presented with chest symptoms. MATERIALS AND METHODS This study was conducted in a tertiary health care centre, New Delhi, India. The study consisted of 45 patients. A thorough clinical history of all the HIV positive patients presenting with suspicion of pulmonary disease was taken. General physical and respiratory system examination of all patients was done. HRCT scans of the chest were done in all the cases taken in the study. RESULTS Maximum number of patients was in age group 31-40 years (24 cases). Out of 45 patients included in our study, 32 (71%) were male and 13 (29%) were female. In our series of 45 patients, 62.2% of patients were diagnosed as having pulmonary tuberculosis, followed by bacterial infection in 20% cases and Pneumocystis jiroveci pneumonia (PJP) in 8.9% patients, while 8.9% of the study did not reveal any significant abnormality. Maximum number (22/28) of patients with pulmonary tuberculosis were indentified to have nodular opacities. The most common HRCT finding in bacterial infection was lobar consolidation. The most common HRCT finding in patients with PCP was diffuse ground glass opacities in mosaic pattern of distribution. CONCLUSION HRCT is a highly sensitive tool for detecting lung parenchymal and interstitial lesions and allows better characterization of the lesions. HRCT findings should always be correlated with clinical findings, CD4 counts and other available investigations before arriving at a diagnosis or differential diagnosis.

Primary tubercular chest wall abscess in a young immunocompetent male.

Chest wall tuberculosis is a rare entity especially in an immunocompetent patient. Infection may result from direct inoculation of the organisms or hematogenous spread from some underlying pathology. Infected lymph nodes may also transfer the bacilli through lymphatic route. Chest wall tuberculosis may resemble a pyogenic abscess or tumour and entertaining the possibility of tubercular etiology remains a clinical challenge unless there are compelling reasons of suspicion. In tuberculosis endemic countries like India, all the abscesses indolent to routine treatment need investigation to rule out mycobacterial causes. We present here a case of chest wall tuberculosis where infection was localized to skin only and, in the absence of any evidence of specific site, it appears to be a case of primary involvement.

Spontaneous Avascular Necrosis of Bilateral Femoral HeadsâÂÂCase Report

Avascular necrosis of femur as the name implies is directly related to the compromising state of the blood supply and their further pathological changes at that site. This results in major musculoskeletal disability. This may be traumatic or non-traumatic as the crux of the underlying problem is ischemia because of disruption of the vascular nourishment. This eventually leads to the death of marrow and osteocytes which leads to osteonecrosis. This shows in imaging in the form of ischemia or bone collapse and the diagnosis is made with the help of imaging armamentarium. The age of presentation and the history are very important to know before the diagnosis is made. Plain radiography, Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) play a pivot role in clinching the diagnosis. We present 28-years old male who reported with pain in both hip joints with painful and restricted movements. He was diagnosed as bilateral avascular necrosis of hips on the basis of the radiological findings.

Arterio Venous Fistula (AVF) of Filum Terminale-MRI Diagnosis - A CaseReport

Arteriovenous malformation (AVM) of the spine can present with different symptomatology. This depends upon the region of involvement and with the background of underlying angioarchitectures. AVM occurrence at filum terminale needs special reference as it is not covered under any classifications. Arteriovenous fistula (AVF) can remain undiagnosed because of the location and the way of its presentation. Rodesch et al. has found as 3.2% prevalence in one of their series of arteriovenous shunts management. Selective Digital subtraction angiography (DSA) is required to find out the arterial feeder for its guidelines to the appropriate management. We present 42- years old male who presented with long standing low backache with numbness in both lower limbs. Contrast Magnetic Resonance Imaging (MRI) investigation of Lumbosacral spine diagnosed as a case of having arteriovenous fistula of filum terminale.